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Current HIT policy discussions are happening at both the state and federal levels

Historically, little federal or state policy level attention has been paid to managing provider identifies. One exception is the National Provider Identifier (NPI) called for under the HIPAA legislation and promulgated by CMS.

However, the NPI basically supports Medicare/Medicaid payments and does not address the broader provider identity management issues, such as those recently discussed at the HIT Policy Committee and its workgroups.

Testimony presented to the workgroups from organizations that today have filled the gap with their own provider directories, such as Surescripts, Availity and Emdeon, illustrated current practices and the complexity of maintaining directories at this level, as well as the efficiencies that could be gained if a national approach is taken.

SureScripts and Availity are Initiate customers who have fostered interoperability across their organizations. Read the SureScripts success story.

Many use cases were envisioned by the organizations, as well as the workgroup members during their open discussion. Let’s briefly look at this heightened demand from a federal and state perspective.

Electronic information exchange can’t realistically function with thousands of point to point communication nodes that must manage provider identification, as well as patient identification.  Rather, directories at a state level, or perhaps even regional level, are needed to manage the various use cases dictated by the vision of information exchange.

Additionally, one of the use cases for the NHIN, sending disability information from the healthcare provider to the Social Security Administration (SSA), clearly illustrates the need to know who providers are, where they practice, and where information exchange requests should be sent. SSA pilots have already shown tremendous value to patients and providers when clinical information can be requested and returned electronically.

Since most healthcare is local, we can envision that information exchange will largely be within a state or across the state boundaries. This scenario will greatly benefit from a statewide provider registry that manages who providers are, where they practice, and other variables.

Initiate® Provider Management can play a key role in addressing this complex challenge.  Initiate’s rapid deployments, ability to support multiple products on one instance, and scalability make it very well suited to help states and Federal agencies in addressing the new demands.

Stay tuned, particularly to the HIT Policy Committee, as the dialogue advances.